Social health policies, freedom of choice and responsibility

Social health policies inevitably raise the issue of the individual’s freedom of choice. While debates around these policies often concentrate on questions of fact, scientific consensus and reliability of evidence, these tend to be surrogates for the underlying values issues. To what extent should I sacrifice my freedom of choice, or my freedom of choice to decide for my children, for the good health of the community? And what if my freedom of choice violates the freedom of choice for others?

He basically talks about the spread of measles throughout California and neighboring states because of a source of infection at Disneyland. Although measles were eliminated in the U.S. by 2000, the misinformation of the anti-vaccine movement has caused a return of a full-fledged outbreak.

Levels of responsibility and consequences

Paul makes the comparison of opposition to vaccination with opposition to blood transfusion.

1: Blood transfusions. A person my refuse to accept treatment involving blood transfusion because of their personal religious beliefs. More questionably they may refuse on behalf of their children. However, the consequences are limited to the person or her child. The decision does not harm the community at large.

2: Vaccinations. A person may refuse a measles vaccination for themselves or their children. But in this case the consequences are not personal – they affect the whole of society. By lowering the degree of immunisation in the community they threaten the lives of others – particularly the most vulnerable, children.

In these two cases the person has refused an intervention, a medical treatment or vaccination, which could be seen to violate their freedom of choice – or even to violate their body. In the first case the consequences are personal, limited to the person who made the wrong decision. But in the second case the consequences are social. An personal wrong decision has taken away the freedom of choice, the health and in some cases the lives, of others in society.

A bit like the personal decision to drive on the wrong side of the road. Society has taken away a small personal freedom of choice in our road rules to protect the lives of all of us.

3: Fluoridation. Social health policies like community fluoridation of water, salt, milk, etc., are recognised as being safe, beneficial and cost-effective. But they are opposed by a vocal minority. Activists will passionately promote the freedom of choice argument and, considering they don’t have the scientific evidence on their side this is often seen as their strongest argument. After all, it is values-based and therefore can’t be tested and rejected by evidence.

But, this third case is different to the other 2.

The act of fluoridation or not is social, taken by society as a whole or their representatives. An person may contribute to the decision but cannot decide the issue by a personal action as they can with vaccinations or blood transfusions. Although individual political action, or dissemination of information or misinformation, may influence that social decision – and hence the social consequences.

Fluoridation does not involve an intervention or treatment, medical or otherwise. No one is forced to drink fluoridated water or milk, or to consume fluoridated salt. The freedom of choice argument is invalid here because there are always alternatives.

Despite actively promoting the freedom of choice argument even the NZ anti-fluoride activist Fluoride Free NZ provides information on these atlernatives. They list alternative water sources, distillation, ion exchange filters and reverse osmosis. Most of these choices are cheap and available.

So what is driving anti-fluoridation propagandists?

Unlike opponents to blood transfusion they cannot argue freedom of choice to refuse an intervention on religious grounds. There is no intervention. The only personal imposition is that they may wish to buy a water filter (many already have these) or buy water from a different source.

Again, unlike opponents of vaccination they cannot argue freedom of choice to refuse an intervention even on grounds of personal belief – because there is no personal intervention.

Given the lack of any forced or personal intervention I am forced to conclude the freedom of choice issue that concerns the anti-fluoride activists is their freedom of choice to decide the oral health quality of other members of their community. And given the health and scientific expert consensus on the issue they are really arguing for their freedom of choice to decide the oral health of others on the grounds of their own minority personal beliefs or convictions.

In last year’s High Court judgement on the question of fluoridation in South Tarinaki, Justice Hansen wrote:

“Provided it does not have consequences for public health a person has the right to make even the poorest decisions in respect of their own health. But where the state, either directly or through local government, employs public health interventions, the right is not engaged. Were it otherwise, the individual’s right to refuse would become the individual’s right to decide outcomes for others. It would give any person a right of veto over public health measures which it is not only the right but often the responsibility of local authorities to deliver.”

The freedom of choice the anti-fluoride activists are promoting is their freedom of choice to decide health outcomes for others – not themselves.

‘Freedom of Choice’ should not be like the Ritz – ‘Open To All’ – if you have the money.
The choices for removing fluoride are not cheap and neither is collecting rain water or buying bottled water.
The justice system in this country may more aptly be called the ‘Just Us’ system since we are so small it’s more like an Old Boy’s Club that has let a few token females join who have been foolish enough to dispense with the Privy Council that at least could give us a more impartial hearing.
The recommendation of the judge to get the law changed before his decision was appealed is outrageous and appalling and any fair minded person would be speaking out against it . . . but of course that’s not one of your attributes as far as I can see.

So green buzzer pleads poverty. He gives the impression he is so poor he can’t exercise his freedom of choice and therefore others must suffer.

Tell me – do you have a water filter at home – at least one for removing bad organic and chlorine tastes? The cost of an ion exchange cartridge is minimal, – less than the cost of a single filling and you wish to impose that on thousands of others.

I don’t believe people who plead their own poverty as a reason for denying the others freedom of choice. If it was important to you then you would pay up.

What is not permissible is that you should use such arguments to deny an effective, beneficial and cost-effective social health policy to the majority who don’t share your hang-ups.

This touches on the previous atheism post where rather than the question of why did create a world where children get worms in their eyes, the question might be why did God create a world with free will where people may choose to ignore others’ disabilities if not to profit from them.

Many people feel the science we are told is frequently a sales scenario and studies are now investigating this:
“The literature search and screening process resulted in 512 included full text articles. We found an increasing number of published preclinical systematic reviews over time. The methodological quality of preclinical systematic reviews was low. The majority of preclinical systematic reviews did not assess methodological quality of the included studies (71%), nor did they assess heterogeneity (81%) or dissemination bias (87%). Statistics quantifying the importance of clinical research citing systematic reviews of animal studies showed that clinical studies referred to the preclinical research mainly to justify their study or a future study (76%).”

Ken do you then discredit the article I quoted from? Only 13% of animal study preclinical systematic reviews look at dissemination bias. And three quarters of these studies are done “mainly to justify their study or a future study” Do you include this author with me and my mates? I’m flattered.

From the material of your article public good intent ought to be more important in systematic reviews.

“I and my mates” not necessarily influenced by the “natural” health industry, but interested in it. The whole organic message is spreading, not just for health but for economics, too, which horrifies you I presume. Check youtube Aljazeera organic farming. Noting of course an organic certificate may not mean you are being sustainable though it is more likely with organics. Wider range of race elements in food, germanium &c.

Ken, as per usual you are using twisted logic. Read the former Republican Presidential Nominee’s position on fluoridation. He is arguably the most well known libertarian politician on the planet.

Former Congressman Dr. Paul:

“The federal government should have zero…nothing to do with the promotion of fluoridation unless its on a military base…and hopefully there they would do the right thing. So no, federal fluoride promotion shouldn’t exist, they shouldn’t be telling you or anyone else what should happen because even though it was well intended at the time–I remember that I thought it was a bad principle because in a way it was massive treatment–and at the time everybody accepted the idea that fluoride was great and that you would never get a cavity and there was no downside, now there is a big question, that’s why you don’t want government doing these kinds of things. You or I should decide, someone should give us bottled water with fluoride, or we should have the ability to buy water with fluoride, but we should not have the federal government promoting fluoridation…sometimes their right, most of the time their wrong. They shouldn’t have the authority to do this. Especially with the information out there now about fluoride, I would do my best to stop federal involvement with state and local fluoride decisions.”

Ron Paul is a physician trained in obstetrics and gynecology and has been a U.S. Congressman representing the Houston area of Texas for over 20 years. He has run for President twice before, has multiple best selling books, and has a very large and loyal following across the United States.

1: You claim my logic is twisted – but you don’t say how. Consequently I reject your claim out of hand as you don’t supply reasoning.

2: You fall back on personal endorsement – yet you are the guys who claim those supporting a scientific understanding of the fluoride issue rely only on endorsements. You guys are always using endorsements and lately have resorted to using the endorsement of dogs – as translated by the owners!!

3: I judge what people say on the credibility of evidence they use and the reasoning they apply. Ron Paul fails completely to convince for those reasons in your quote. That is not say he is always wrong (he has said some sensible things on the Ukraine issue recently) but he obviously is wrong on the fluoride issue.

Come on Kane, can’t you do better. You are one of the dwindling list of leaders of the local anti-fluoride movement at the moment but you can’t even address my freedom of choice arguments. The people on your side must be really dissatisfied with you.

WTF – Kane is not interested in my thoughts in the NZ fluoridation Review. So why is he asking me to do anything??

What is wrong with the guy?- is he too scared to approach other people or something? Why must he ask me to do this for him? Especially as I am not known to have any specific link with them.

Now if Kane is not getting a response to his questions perhaps he hasn’t got the right contact address, hasn’t actually asked, is too rude in his requests, or comes across as one of those nutters that people in these positions must be pestered by and can only ignore.

It’s not as if these agencies ignore honest requests, Kane.

I sent my own critique of the Review to both offices and got a response within a few days from the main author. What’s more the response acknowledged the mistake I had identified and corrected it, together with another typo they identified.

I actually think the FFNZ critique is rather childish so can understand if others do not want to bother responding too it. However I did, in a very detailed way. I also offered each author, and so-called “peer-reviewer” the opportunity to respond to my critique. They all refused. I drew the appropriate conclusions from that refusal.

So Kane, what about you approaching those people, authors and “peer reviewers” used in your organisation’s critique and asking them to respond to me?mthat would be the honest thing to do. But you won’t because you don’t have a leg to stand on, do you?

Ken, I’ve contacted Anne and asked for a response. Let’s see what she comes back with. If your response took a few days we’ll see how long it takes. Thanks for letting me know that she responded to you.

“It’s not as if these agencies ignore honest requests, Kane.”
“got a response within a few days from the main author”

Thanks again for the idea to ask Anne directly Ken. We will look forward to the response late next week. Although Skegg did say this didn’t he:

“As you will see below, however, (name withheld) is questioning the feasibility of our approach. As you know, I have always had concerns that (quote withheld) – whereas the benefits of fluoridation can be summarised succinctly – the literature on potential risks is vast and quite complex. I can understand why any reputable scientist would be reluctant to put their name to a report if they have not had time to take a first-hand look at the evidence. Also I do not know whether (name withheld) has familiarity with epidemiological concepts and methodology.”

Do you envisage that we could present our report as a synthesis of reviews by reputable evidence-based groups in other countries, as suggested in the correspondence below? Otherwise I think we need to consider a much longer gestation (the latest two policy papers from RSNZ Fellows took the best part of a year) and it will not be easy to persuade a first-rate epidemiologist to take on this task.http://fluoridefree.org.nz/nz-review/nz-review-critique/nz-fluoridation-review-timeline/

As for vaccines the message these days is that individuals may need to take more shots against some things. Vaccine immunity wears off unlike for measles immunity acquired from non-vaccine-strain measles. So an embryo may be damaged if enough shots aren’t taken by the mother.

As for fluoridation the level is being decreased. Dunedin has recently decreased their level by some 13%.

Two-valued thinking is a bane of the addictive personality. “A substance like alcohol can only be good or bad.” Gradually, though, many of the public are catching on to “some is good, more maybe bad.” Dose-benefit curves are not straight lines.

I’ve been taking a quick look at natural radiation and cancer in some NZ cities. It’s rather rough. I don’t have the age distributions. I am enquiring into a notion I think I once heard that fluoride is related to cancer. As I noted on another thread I have variables for 6 NZ cities latitude, cancer rate (non-melanoma) in 1983, years of fluoridation up to 1983, and now am adding radiation dose related to radon, a radioactive gas which gives us about half of our ionizing radiation dose. My figures are a bit rough, for example Wellington has quite a wide range. Roughly averaged figures from Robertson and Randle’s book.

Radon increases with latitude in NZ. (But it is less than many countries). My figures seem to show that at the low level we have here, a bit more may help against cancer in the epidemiological sense.

Likewise at the levels of fluoridation we had around 1983, more years of it seems to have reduced cancer. The range is only of a few years. When I partial out the effects of radiation and latitude (latitude increased cancer) I still get a negative correlation between fluoridation and cancer.

I suspect if my figures had come out against fluoridation I would have been subjected to strong attack from pro-fluoridationists, and not necessarily scientifically-based attack. But you can attack me a bit for posting this while I still have the problem of understanding how the correlation between latitude and years of fluoridation goes higher when cancer and radon levels are partialled out.

Oh, sorry, I forgot, cancer was rank correlated to radon at 0.48 till I partialled out latitude which reduced it to 0.04, or years of fluoridation which reduced it to 0.14, or both at once which increase it to -0.33, now a negative correlation Puzzle. Wonder if anyone may chip in and help. If we understood analysis better perhaps we would overcome some troubles of rejecting stuff when we shouldn’t.

“I’ve been taking a quick look at natural radiation and cancer in some NZ cities.” Why mention it here? It’s irrelevant to the topic. Ken’s title is “Social health policies, freedom of choice and responsibility.” Nothing to do with natural radiation and cancer.

“Radon increases with latitude in NZ.” Um… no. Radon concentration anywhere in the world is entirely dependent upon the geology of that area. It has nothing to do with latitude, longitude, or even altitude.

Since your maths is based on a false starting assumption, let’s just ignore it and get back onto topic, please.

““Radon increases with latitude in NZ.” Um… no. Radon concentration anywhere in the world is entirely dependent upon the geology of that area. It has nothing to do with latitude, longitude, or even altitude.”

There would be a bit of variation in geology in Wellington going by the radon figures.

But sorry perhaps I should have said ranking radon levels of 6 cities from Auckland to Dunedin using figures from “Natural Radiation in New Zealand Houses” By Robertson, M. K. 1988 shows some correlation with latitude of those cities.

Actually Christchurch is the highest. Not sure if that relates to the radon coming from our artesian water, if you call that geology.

Richard: “As for vaccines the message these days is that individuals may need to take more shots against some things.

“these days” – Where has Soundhill1 been for the past fifty years?”
I just said
“Ha ha,” because Richard is turning the message back to the “more is better,” hypothesis.

Richard is not specifying whether his claim is of rate of vaccinated people without attending to whether they have had enough booster shots, the latter being obviously what my comment was about. In China where vaccination is nearly universal I think they are looking at need for some more boosters.

I wrote: “As for fluoridation the level is being decreased. Dunedin has recently decreased their level by some 13%.”

Richard wrote: “So what? Without proposing an reasoned conclusion along with the observation it is meaningless, albeit heavily weighted with innuendo, which is perhaps the goal that you are trying to achieve.”

My message is that an either-or argument may not respect the intelligence of many people, so likewise they may not respect in return. People have to respected for having some nous. Though politicians and their hacks may try to override it.

Political masters find it easier to manipulate people by dividing them into opposing camps attacking one another.

Richard do you think it a weakness that the Dunedin people have chosen to reduce their fluoridation level from 0.85 to 0.75?
I think that because you are immersed in the two valued system you are frightened that reduction suggests eventual cessation. Whereas the Dunedin people are looking for an optimum level.

Ken you wrote:
“Activists will passionately promote the freedom of choice argument and, considering they don’t have the scientific evidence on their side this is often seen as their strongest argument.”

And now you write

“Soundhill, you are burbling again. This is not the place for such evidence and data-free speculation dressed up in a sciency frock.”

I’ve now given the rough data.

I think we can do better, than “trust us, we know, we are scientists!” Help with understanding. Freedom of choice may then turn from an “either or” matter into a “how much” matter.

I asked a dentist for advice. He offered counselling that as a dentist he may sometimes be offering opinions for my treatment which suit himself. So he was saying I need to apply my own logic for some choices. I was lacking in data to base them on. When people do not have the data they are easier to manipulate. And I have to say anyone trying to marginalise discussion, help and learning must justify that.

“It is simply no longer possible to believe or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” —Marcia Angell, MD (“Drug Companies and Doctors: A story of Corruption.” NY Review of Books, Jan. 15, 2009.)

Thanks bbinc. Marcia Angell changed sides. “In The New Republic (“Tempest in a C-Cup: Are Breast Implants Actually
OK?” 9/11/95), New
England Journal of Medicine executive editor Marcia Angell restoked fears
that an embargo on
silicone implants posed a “threat to all medical devices.” The Journal,
which published the Harvard
and Mayo studies,”

“”The greedy plaintiff’s attorneys have created this hysteria” is but one
of the many myths, huge, PR machines fueled by deep, deep pockets and no
conscience have sold to the American public. “Saline implants are
perfectly fine, perfectly safe” is another. These falsehoods and
countless
others are part of the dis-information churned out by the
mega-manufacturers whose devotion to their bottom line supercedes any
modicum of truth or concern for their customers. No plastic surgeon
mentions the overgrowth of fungus, mold and bacteria that finds fertile
breeding ground in these salty petri dishes. The ill and disfigured
plaintiffs are treated like rape victims ~ blamed for believing the lies
of their plastic surgeons. The “scientific studies” paid for and
orchestrated by the manufacturers are merely a gross manipulation of the
medical, legal and political systems.”

So bdbinc – do yoiu want to take away the freedom of choice of a community where the majority has decided to utilise a safe, beneficial, cost-effective social health policy like CWF – but give that “freedom of choice” to those who, on the basis of ideological prejudice, wish to prevent the adoption of such a policy.

Pathetic “freedom of choice.”

Filling up on the crap from Fluoride Alert does not amount to being informed. In my experience the anti-fluoride propagandasts are far from being “informed.”

One does not have to be a scientist or physician to put one’s trust in reliable science and health experts. This amounts to “informed consent.”

Shane – most countries in the woirld do not have safe drinking water. And I think the data for oral health in NZ shows that those living in fluoridated areas actually get along better than those in non-fluoridated areas.

But you did nothing to engage with my article – which is an argument in ehtics and freedom of choice – at all. You anti-fluoride propagandists always fail at ethiucs.

Radon and latitude are both found outside of New Zealand. A good first test of your assumption is: how does it extrapolate to the rest of the world? Since it doesn’t extrapolate, it means that your assumption is likely to be wrong.

I thought that, given the hint you were wrong about radon and latitude, and a further hint that radon and geology were related, you would have looked up the relationship between radon and geology.

Yet another hint: in general, radon derives from volcanic rocks.

Now since your initial assumption was wrong, we can ignore any calculations based on that assumption. They have to be wrong as well.

Soundhill ought to finish his (many) research projects (even one would be an achievement), write up his results and have them reviewed and published. Then we’ll be happy to discuss them here. This isn’t the place to subject us to a torrent of half-baked ideas and conjecture and demand or expect discussion on them.

To put one’s trust in the health industry, blind trust in big pharma’s pseudo science industry and trust a failing industry of ignorant and corrupt “health experts” (who from recent documentation many are lying to the public about vaccine efficacy and safety ) is not informed consent.

bdbinc – your blind trust in Paul Connett and Fluoride Alert is misplaced and not informed consent. It is reliance on a discredited propaganda outlet for the “natural” health industry which promotes a naive psuedo science movement. It relies on people who are corrupltly benefiting from the ideological commitments of naive anti-science people.

Here is a debate I had with Paul Connett which exposes his methodology and the way he misrepresents and distorts the science – Fluoride Debate. You can download it as a pdf.

The science of CWF is well understood. It is safe, effective, beneficial and cost effective. It is understandable that the ordinary person in the street should put their trust in the engineers and scientists who have researched this (nothing to do with “big pharma” – they do not profit one iota from water fluoridation unlike the “natural” health industry which profits from the anti-science fear mongering of the anti-fluoride propagandists).

So why not engage with the content of this article instead of promoting your own ideology?

You are promoting your ideology. When faced with facts and proof of the corruption of science by industry you just tell people trust (in big money that has corrupted science )constitutes informed consent.
Your dispensing ideology of trust in place of informed consent for health does not do science proud.
I gave you solid links to evidence about corrupt pseudo scientists in the vaccine industry, your ideology of blind faith is out of the closet.
*Soundhill1 Ken’s response to anything other than his “blind faith in a corrupt industry ” has not changed as he falls to the same old ad hockem bantering.
Ken the corruption of science by industry and the conflict of interests are clearly demonstrated and widely known by many people today.Over one billion people were shocked at the exposure of the corruption of the scientists in the CDC vaccine scandal.Thank goodness for whistleblowers. Telling the public a lie that trust (without being informed) is informed consent is not going to work anymore- it makes you look untrustworthy .

OK bdbinc, what about some evidence. Tell us, with data and evidence, how “big Pharma” is perverting the science behind fluoride and what money it makes out of CWF. Put up or shut up. Here is your big chance – but stick to fluoride and fluoridation please as this was the subject of your original attack.

And what about responding to my point about the links between big “natural” health and corrupt distortion of science like Fluoride Alert and Connett.

Ken,
Late on In your pdf debate with Paul you referred him to a study in Korea 7 years after fluoridation had ceased, in one region and had never been in the other. Where fluoridation had been the 6 year old children born after it had stopped had more tooth decay than where fluoridation had never been. That is then contrasted with the converse in the 11-year-olds and claimed as a systemic effect.

“CONCLUSIONS:

While 6-year-old children who had not ingested fluoridated water showed higher dft in the WF-ceased area than in the non-WF area, 11-year-old children in the WF-ceased area who had ingested fluoridated water for approximately 4 years after birth showed significantly lower DMFT than those in the non-WF area. This suggests that the systemic effect of fluoride intake through water fluoridation could be important for the prevention of dental caries.”

But there could be a confounding factor.

I feel that the constancy of mouth fluoride levels. low and not much affected by a large factor in fluoride dose, indicates the body is working hard to achieve fluoride homeostasis in the mouth. (ref previous topic).

I hypothesise that a controlling gene might be switched and epigenetically inherited.

For the children 6 years of age in the area whose fluoridation stopped 7 years ago: remember conception is 9 months before birth and it takes sperm another month or two to get through the epdidymus. So the sperms would have been created by a father’s body thinking its offspring had to relate to high fluoride. The baby could be conceived and start to form pre-teeth with the wrong genes switched for the fluoride environment it was then developing in.

That is in contrast to where there had not been fluoridation where the gene would be switched differently.

I don’t want to presume that the fluoride-sparing gene switch or the fluoride-wasting gene switch is the “normal’ condition.

But I want to warn against sudden large increases or decreases in fluoridation until this is investigated. Those children should be checked for other differences.

Even if not a gene-switching effect I believe there is need for caution with sudden fluoride changes. People may not have heard of such troubles as rebound scurvy when vitamin c supplementation is stopped. Or they may not know of a rebound effect of stopping some statin drugs. I think may triple death rate. Why would they be the only rebounds?

Extra note, when there is any doubt studies using the word “significant” ought to say whether they mean clinically or statistically.

Ken you say you review research. (I don’t know if you have ever done any involving partial correlation.) We don’t know if what I say bores all other readers. (And it’s possible to read these blogs in the future unless you cancel them.) Two or three responders have argued in ways which makes me feel false thinking is being cultivated, I am not sure if intentionally. But I hope people are not being left with mistaken ideas.

This may be a minor blog. Once I get the feeling for all you have to offer I may go to other blogs you are on and start working there. Get different responders from Richard and Stuartg. Or go back to sci.med.dentistry, sci.med.nutrition &c. sci.stat related groups. But such groups are not what they were before Usenet newsfeeds stopped blogs came in. People used to argue but also be very helpful to one another.

In your comments on Ken’s blog, you have said that you “hypothesise,” “think,” and “calculate” on many areas. You then comment on those multiple areas.

Rather than commenting straight away, the next step in the scientific method is to do some background reading, maybe talk things over with colleagues. Check out any assumptions made, see if they are valid assumptions. See if anyone has already done the research and documented it for the world to see.

As it is, when you place your comments, the appearance is that you have not done any of this. There are frequent errors, maybe in basic assumptions, maybe in selecting wrong data, maybe…

Many of your errors could be corrected before you commit them to the ‘net by looking up basic textbooks. I’m not talking about front line, peer reviewed journals, I’m talking about the basic textbooks, ones that can be ten, twenty, even fifty years old. Your errors are basic errors. Example: I learned about radon and volcanics at school in the 1960s!

I’ve pointed out only some of the errors in your assumptions or thinking. They aren’t the only ones, you’ve made many others. I expected that someone who claims to use the scientific method would use the feedback to review their own thinking and assumptions. Unfortunately, that’s not what you seem to do. You seem to compound your error(s) by going further and further into minutiae without even considering that you could be wrong with the basics.

Before you commit your thoughts to the ether, please consider them carefully. If the basics are wrong, you can expect to be shot down. If your comments are valid, then discussion can occur.

And, please, realise that many people are attacking the errors you make, not the commenter.

Ken I ask you to try to remember the topic of this thread: Social health policies, freedom of choice and responsibility.
You talk about vaccines in the thread and I provided you with links on latest information and science that proves the public was/ is not given the choice to give informed consent.
You told the public to just to trust the current corporate “junk science” whose propaganda is used to promote and protect political ideology .
Although all academic scientists are quite aware of the problem of dishonesty and corruption in science, there generally is not formal discussions with the public about this issue. There is a denial of the corruption of science by corporations. This corruption includes promoting and protecting political agendas (- the NZ govt is a corporation).
As science and thought are also free to the public, your contributing argument of the corruption of science, was telling to have blind trust in corrupt industry (or a scientist who is funded by a corporation to promote a political position) this is not scientific thought. It is political thinking.
The corporation cannot allow the public to know and wants( and needs) them to trust. People are waking up from the sleep of misdirected and undeserved trust in the corporations that have deceived them . With the corruption of science widely known by the public your telling people to trust a corrupted field is not going to cut it anymore.
Informed consent is not defined as “trust” you are wrong . Informed consent is being fully informed and giving consent to something. Vaccines and fluoride in the water are examples of things that the people are not being given a choice, fluoride in their water, but are also not being allowed to give their informed consent.http://www.amazon.com/The-Case-against-Fluoride-Hazardous/dp/1603582878
You Ignored all proof and evidence also the provided CDC Vaccine whistleblowers scandal .

Fluoride.
Mass forced medication in NZ, there is no choice, there is not informed consent .
You haven’t mentioned to the public there was no studies done prior to the 1950 release of the toxic waste product fluoride, carried out by the corporation of US . The mass forced medication of the public was( and is) done without informed consent, without proof of its efficacy or safety, back in 1950 there was also no proof forcing the public to take a drug to reduce thyroid activity prevented dental cavities or was safe.http://www.fluoridation.com/atomicbomb.htm

Yes, Bdbinc, I did mention blood transfusion and vaccination in my discussion. However, the article was clearly identifying that when anti-fluoridation propagandists talk about “freedom of choice” they actually mean their own minority freedom of choice to prevent the rest of the community having access to a safe, beneficial and cost effective social health policy like CWF.

They are imposing their own hangups on the community as a whole.

I am not interested in a detailed discussion of vaccination issues at this stage so have not accessed your links.

Now you rave on about “junk science,” the “corruption of science” and the role of industry. Having worked as a research scientist and actually experienced the reality of the situation, seen the science processes in action – warts and all, and yes having experienced attempts by industry interests to distort the science and prevent me from publishing my own research I can assure you that the science process does suffer from problems – like any human enterprise in the real world. But the problems are not as extreme as you claim in your conspiracy theory. And there are several factors in the practice of science which help reduce such influences.

But here is how you make yourself look very silly. You will reject any of my discussion of the science, my analysis of the scientific literature, etc. but instead promote, for example, Paul Connett’s book. Hilarious because Paul is very proud that he has 80 pages of citations in his book. Many of them are repeats or broken links to Fluoride Alert, but his pride originates from his claim to be reporting science, to be reporting facts and evidence in the scientific literature. The very “junk science” you attack!

No why should you accuse me of using “junk science” while you endorse Connett’s book because it uses exactly the same science in most of his arguments?

Why?

Have you not thought this through?

If your read the articles in our Fluoride Debate you will be able to see that the problem is not the science, not that huge repository of scientific knowledge that both Connett and I cite. It is in the misinterpretation and distortion of the science that Connett indulges in. Again and again in our exchange I pulled him up for this misrepresentation and distortion.

Why should Connett do this – after all, we are of similar age and have a similar background. Both of us have PhDs in chemistry?

Connett does this because of his ideological commitment to the pseudoscience of the “natural” health industry. He is organisationally linked to that industry and financed by it.

Your comments on “junk science,” “corruption of science by corporations,” “promotion of political and ideological agendas, corrupt industry, and blind trust in these, apply very much to the “natural” health industry. It is telling you ignored my comments on this and refused to respond to them.

As for “forced medication,” we all know that fluoridation is not medication in NZ by law. And no-one is forced. Surely you should understand that everyone has freedom of choice – what ever their level of understanding or misunderstanding – on what water sources they use or however they treat the tap water that is provided.

The claim of consumers being “forced” is simply a dishonest gambit to attempt to impose your own hangups on the rest of the community. To deny them the choice they have democratically made (in most cases) to take advantage of a safe, beneficial and cost effective health policy.

From the point of view of the rank correlation I was doing, I didn’t give the figure, but it was 0.77. between radon and latitude. The is not a correlation of 1 which it would have to be if there were a direct relation of the sort chemists or physicists usually deal with. (Except in some quantum statistics sorts of things, and maybe the water molecule sort of stuff.)

It does not matter whether there is an actual relationship or not, it is only the statistics I was talking about.

Readers are presumed to read in context, and the context was statistical, but how would you have put it?

(We know that correlation is not causation. But if there is causation there will be correlation. It may be a first step, except that with say 95% significance it will happen by chance 5% of the time.)

Maybe I can relate shallow quakes to some extra radon and football
wins.

Had a look at UK radonhttp://www.ukradon.org/information/ukmaps/englandwales
Which, though both low, puts Manchester catchment area radon a bit greater than Birmingham. But that won’t explain the sudden differential between Manchester and Birmingham football 8 years after the start of Birmingham fluoridation.

Stuartg thanks for helping me brainstorm though you don’t want to do you?

Fluoridation may have benefits and costs. Do we want to run it like everybody is rated for public transport though they may not be able to use it and would rather spend the money for bike repairs?

And stop trying to divert the issue. My statement was that anti-fluoridation propagandists interpret the freedom of choice they talk about as their freedom to impose their minority choice in the community who actually want a safe, beneficial and cost-effective social health policy.

McKenzie is a large area of middle South Island which I think was cleared of forest by burning a very long time ago. Now it is an unirrigated land which serves as a habitat for special species. People also like its character, and don’t want dairy effluent going into rivers.

Put that against the benefit to the dairy corporates and the supposed economic benefit to all NZers of irrigation.

You talked of fluoride in sea water, but it is there in combination with chloride and iodide. I liked being salty after a swim when I used to go in regularly.

Our skin is not an isolating barrier. “chemicals” on or formed on it are able to be absorbed. It is populated by useful bacteria. Bathing in fluoridated water is likely to change the skin’s ecology. The balance of sweated out minerals will be changed with the addition of fluoridated water.

The claim that fluoride is “systemic” I think needs to be adjusted. I have not seen the figure for by how many dmft the systemic effect claimed in your reference for Connett is.

A study by Yao and Groen I referred to gave low level of salivary fluoride, scarcely different between drinking fluoridated and non-fluoridated water after some minutes delay. They commented maybe fluoride was getting from water on to teeth to explain reported tooth health difference.

So it may be necessary to come to some compromise about including both systemic and topical effects of fluoride. And I would say on skin, too, from showering in fluoridated water.

Just as some people like the McKenzie Country without cubicle dairy farms maybe some people should be allowed to have a their showering in natural unfluoridated water with some radon in it. You say fluoridation produces a saving so their should be plenty of money to shift families and provide daily transport to work.

Soundhill â what evidence have you that F is absorbed through skin by contact with water? Seriously, what is your evidence seeing that the reviews and texts usually say there is no evidence for this?

In fact, to get across cell membranes it appears that F must be in the HF form â making it possible in the stomach. We do not bath or show in HF.

Ken I find it hard to imagine that skin microbiology is not going to be affected by the fluoride ion which is lipophilic.
“The weakening of lipid metabolism by fluorides is due to repression of the activity of a number of enzymes responsible for lipid transformation: triglyceride lipase (4,5), some nonspecific esterases (6,7), and the complete blockage of pyro-
phosphatase activity (8,9), which causes repression in the oxidation of fatty acids”

I don’t know what they may do to the lipid based formation of vitamin D, or to the skin synthesis by microbiology of vitamin B12.

Fluoride absorbed by drinking is diluted by the body, but if as you say it cannot be absorbed through the skin, evaporation of the water from the skin is going to concentrate it there from bathing water.

If he’s a Buddhist and a vegan (though I read the Dalai Lama may not be) then he may be short of vitamin B12. Symptoms take a while to show. I am not sure if it may be synthesised and absorbed in the colon by some people, or on the skin.

But the vitamin D synthesis does not require microbiological organisms as far as I know. Sterols (like cholesterol) are irradiated by UVB to previtamin D and take hours to days on warm skin to convert to vitamin D3 and absorb. I don’t know if fluoride may help or hinder the process. But it is fairly sure it will take part.

Need to take care of skin microbiology. If good ones get hit it makes space for bad ones to grow. A few weeks after starting to use an anti-bacterial hand wash I got a small abrasion near my index finger nail and it got a flesh eating bacteria in it. It was rapid and scary.

@Richard Christie:
“Question: Soundhill what evidence have you that F is absorbed through skin by contact with water?

Response: Ken I find it hard to imagine that skin microbiology is not going to be affected by the fluoride ion which is lipophilic.

[Translation: no evidence }”

I did not give Ken evidence, because I accepted his word that it doesn’t go through.

What I had said:

“Our skin is not an isolating barrier. “chemicals” on or formed on it are able to be absorbed. It is populated by useful bacteria. Bathing in fluoridated water is likely to change the skin’s ecology. The balance of sweated out minerals will be changed with the addition of fluoridated water.”

Nothing there about the fluoride going through the skin.

Ken doesn’t like the idea of people wanting to be rehoused away from fluoridation. So he makes up a straw man and challenges that. People will learn to see through such techniques.

I took the lipophilicity concept from Machoy-Mokrzynska et al. I’ll look into that some more. Maybe they were thinking of drugs containing fluoride in order to be absorbed more easily into fats.

I see the soil bacterium Streptomyces cattleya can put fluoride into organic compounds. Maybe we will get some on our skin.

Apparently fluoride ion is so electronegative that it holds water molecules around it, supposedly isolating it.

Also note Pollack’s claim that pH in water near a surface can increase, which he showed with an indicator dye. That may change what can happen to fluoride, especially if light is present.

But just saying again, I was not claiming the fluoride goes through the skin, just that it may change what happens on the skin, possibly related to vitamin D synthesis &c. The skin is an organ.

Which applies to fluoride? Hint: fluoride can be dissolved in community water supplies. It can’t be dissolved in olive oil”

No but an enzyme or enzymes can cause it to compound with a constituent of olive oil, oleic acid: the compound is ω-Fluorooleic acid 25, though it may be only in another plant. (Stuart Cross PhD Thesis).

“Social” policies may tend to average out everyone. It is gradually becoming more widely know how the Kremlin, in the early 1930s, was not keen on the Christian Kulak peasant farmers keeping their individual plots of land. Stalin announced the “liquidation of the Kulaks as a class.” Six million dies is an estimate in the “Holodomor,”: they were denied food.

Thanks Stuartg for reminding me to research papers more. I didn’t before posting the seemingly negative rank correlation between years of fluoridation and cancer. Now I have started and I see that at low but varying levels, some types of cancer increase and others decrease. My feeling is that those who have a genetic predisposition to cancer in various parts of their body should be allowed more or less fluoride depending on the possible cancer site. Unless you believe teeth are more important than cancer.

Soundhill, you are just as bad with history as with science. You should put more effort into checking facts and sources. In Ukraine the famine which struck their area, and parts of Russia in the 30s is used to hit the Russians with, despite the fact they suffered too. And did not the Russians suffer under Stalin?

Typically Ukrainian nationalists inflate the figures (more like 1 million died in Ukraine), and commonly illustrate “Holodomor” with photos taken by a Norwegian photographer of the famine in Russia in the 1920s resulting from the civil war.

And come off it, comparing a safe, effective, beneficial and cost effective social health policy like CWF to forcible nationalisation of private land under Stalin! Next you will be telling us the Nazis used fluoridation in the concentration camps to keep the Jews docile!

So what do you say of Ken’s statement at the end of his dialogue with Paul Connett?:
“And, of course, there is always the possibility that
future research may change the current scientific consensus that fluoride at the levels used in water or salt fluoridation is safe and beneficial. Science is like that. Because our knowledge is
always provisional, but improving over time, we sometimes do modify our conclusions”

And please note there is a difference between water fluoridation
and salt fluoridation which should not be conflated. It is more easy to allow people with predisposition to cancer at various sites on their body to increase or decrease their dose with salt.

Soundhill, I object to you using a perfectly reasonable statement of mine to support your crazy ideas.

The fact is that all the science to date indicates that water fluoridation at optimum concentrations is safe and effective. The only slightly negative problem is its contribution to mild dental fluorosis – which occurs in unflouridated areas anyway. And is usually considered positive from a quality of life perspective.

Now future science may change that assessment – but I mean evidence-based science not random speculation. It is easy to dream up all sorts of logical possibilities but it is dishonest to present them as science, let alone evidence-based. Or as argument for stopping a well accepted social health policy until you silly conclusions are tested.

My perfectly reasonable statement which all scientists would agree with is no justification at all for your ramblings on a bog comment. Please don’t try to rope me in as supporting such rambling and the completely unreasonable conclusions these produce for you. That is not science.

I’m a generalist with wide knowledge. I know the areas where my knowledge is lacking and will readily admit to the areas I lack knowledge.

Some commentors, particularly on this blog, develop extravagantly constructed, multifaceted hypotheses in an attempt to cast doubts on certain well established areas of science.

Being a generalist, I can often see where the foundations for those hypotheses are fallacious, where they have been known to be erroneous for decades.

More than anything else, that’s what started me commenting on some blogs. I just don’t like to see those hypotheses getting more and more ethereal when they aren’t connected to anything solid. I believe it’s much better to apply the otherwise wasted thought and energy to something that has solid foundations.

Ken, can you refer me to a systematic review of articles on cancer site, sex and levels of fluoride relevant to fluoridation? I have just shown 2 articles which might be considered in such a review. The first says its positive correlations, to the extent they are, could be chance. But the second is finding similar pattern so is reducing the possibility that the result is chance.

Is there dissemination bias, since it would seem the negative correlations found for a number of sites would be a pro-fluoridation argument, but hampered by the positive ones.

Though you were provided with all evidence you chose to ignore it and spread corporate propaganda, guess I couldn’t have expected anything better as thats what you are funded by the corporation( nz govt) to do.
Its a simple case of a conflict of interest as you are paid to support a political position .

People did not and do not have a choice on the matter the corporation is still forcing mass medication of fluoride.
And you are incorrect preaching people should just “trust” in an industry that has been exposed as corrupted is pure stupidity.
And you are wrong, informed consent is not trust.
Time are changing and many people are waking up to the current state of corporate funded ” junk science” and the political propaganda dressed up as science.

Comedian George Carlin speaking about the corporation ( govt) put it this way:
“Sooner or later, the people in this country are going to realise the government doesn’t give a f*ck about them. The government doesn’t care about you, or your children, or your rights, or your welfare or your safety. It simply doesn’t give a f*ck about you. It’s interested in its own power. That’s the only thing. Keeping it, and expanding it wherever possible.”

Problems of science politics have been going on for quite a long time. It would be interesting to know the real thoughts of Soddy, co-worker with Rutherford, as he tried to get published a model of the atom with central electron and orbiting protons.

Soddy had been trying to fight oligarchy in the Royal Society, and make science more of a social leader.

The way I dream it Soddy may have been trying to say how silly the control of science by the military oligarchs is.

I think we still have that authoritarian overhang, but now it is not just country against country forcing obedience but corporate dominance.

The central core is afraid to listen too much in case something may come up which challenges the sciento-corporate framework.

A big one is GMO business expansion. I think it is one reason why Monsanto mercenaries have been in Ukraine.

Fluoridation is pretty small but opens a crack in the dominance philosophy.

Soundhill, your wishful statement “Fluoridation is pretty small but opens a crack in the dominance philosophy” reminds of the Wedge Document whereby Christian extremists in the US hoped to overthrow evidence based science and replace it with a theistic science.

Fluoridation has a sound evidence base for its safety and effectiveness. But there are corporate interests who see fluoridation as a weak point through which they can drive their profit motivated wedge. Connett himself has exposed that thinking, seeing fluoridation as the first step, followed by vaccination and then by evidence-based health science in general.

Is see your confused ramblings in which you make a completely unfounded prior assumptions that fluoridation is dangerous and then frantically search for anything you can use to discredit it as just another part of that wedge. It is making you look ridiculous and you get unanimous criticism for it.

And you continually avoid the evidence that has been presented to you for how the business, profit-based interests of the “natural” health industry is financing much of this attack on fluoridation. You defend Mercola for his opposition to evidence-based science and pretend you don’t hear about how he finances the Connett Crowd. Your close your eyes to the big money from the NZ Health Trust financing the High Court actions against fluoridation.

I suspect with this sentence you have let slip your conscious understanding of the tactical significance of the anti-science attacks on fluoridation. A bit like Obama when he let slip recently that the U.S. brokered the transition of power in Ukraine – in other words they engineered the coup!

Unfortunately my nutrition books are hidden away as a result of the quakes. Roman Kutsky would be one author: “Vitiamins, Minerals and Hormones” Can’t remember other names at the moment. Bought them from N M Peryer amongst the medical texts a long time ago though I was not formally studying.

Excess alcohol can produce a B3 shortage. Or “fad” diets, maybe Ken can comment on his Buddhist friend’s eating habits.

Got to be careful with large doses of niacinamde = nicotinamde, or time release doses which may harm the liver.

Niacin = nicotinic acid may be prescribed by doctors to open capilliaries, I am told it gives a buzz.

I don’t know about now but I don’t think doctors got much training in nutrition. It was just presumed our diets were adequate. And doctors probably have not caught up with the tremendous change of the ratio of omega-6/omega-3 in our diets, which actually has been happening for a long time, resulting in demand for anti-inflammatory drugs.

What doctor bothers to check zinc and chromium levels of a patient before or in addition prescribing metformin or insulin?

The Pharmac website documents all of the medications available to be prescribed in NZ. It’s a good place to start when looking for any medications in NZ.

It also documents the discussions that take place, and the evidence for and against each medication. The omegas have been discussed, and the reasons why they are not available on prescription are on the website.

As for niacinamide – the Pharmac website reports that no-one has ever requested that it be available on prescription. Since the request can be made by anyone, maybe you should do it yourself since you object to it not being available.

All you have to do is summarise the research, supply reliable references, look into the costings, produce a cost/benefit analysis for the country, list indications, contraindications, doses, interactions, adverse effects. Forward all of these to Pharmac and they will then consider your proposal.

You are correct in that doctors don’t get much training in “nutrition.” They actually don’t get any unless they do a paper in sCAM (supplements, Complementary and Alternative Medicine). Instead they get training in diet.

As Ben Goldacre says, anyone can call themselves a nutritionist. They don’t need any training at all, and many haven’t actually had any training. He gives many examples of such untrained “nutritionists” in his book and on his website.

However, the professionals are the dieticians. They have to go through rigorous, documented training, and then have to be professionally registered. Doctors only have some of the training of dieticians. That training is sufficient for them to recognise a dietary problem and then they refer the patient to the true professionals, the dieticians.

Diet, that’s another of my old books, “Human Nutrition and Dietetics,” by Davidson and Passmore.

From what I read doctors just trot out scripts maybe too frequently even an anti-depressant when and anti-biotic is needed. They treat symptoms, not heal causes, which is why the alternative medicine elephant is growing, though “science based medicine” is trying to stamp it out.

I am still waiting for satisfactory communication from a public health professor about the place of human contact in health.

Soundhill, I think you are correct that “natural” health professionals can sometime offer a better service than doctors. They can often spend much more time with each patient and that in itself can have psychological and psychosomatic benefits.

Of course the answer is to improve the system so that doctors can spend more time with patients and recognise when other professionals with counselling skill may be more appropriate (and more cost-effective).

And I think it is true that some doctors over-prescribe with things like antidepressants. But others do not. I am fortunate in that my doctor has been excellent, does not overprescribed and attempts to manage my medication sensibly. (Mind you, my cardiologist does a better job with managing medication – but then again he is the specialist). My doctor also has relatively good communication skills and I do appreciate my regular appointments with her even if waiting times can be a problem. As in any interactions with specialists, some are better than others and a wise patient recognises this and acts accordingly.

My partner is a cancer patient and I have found that our oncologist often has to deal with emotional issues and and pretty good skills in that. He also devotes a good time to consultations (although it is frustrating for other patients waiting), is a good listener, etc.

But on the other hand, many “natural” health professionals are dangerous in their anti-science attitudes (although even Mercola has fine print advising readers to consult their own doctors – his legal let out). And that danger is fed by an anti-science ideology which is promoted by a profit-driven and largely unregulated industry.

So Soundhill, I know you are ideologically obliged to condemn and misrepresent our health system (and to be very silent about the faults and profit and ideology-driven nature of the “natural” health system you promote) but your dogmatic rants are not convincing.

When you are talking cost/benefit aspects of “the country” you are talking about big business.

Canada are trying to reduce the costs to “their country” of medications but are finding “their country” is a little subsidiary of Eli Lilley who want its $500million cut and threatens to list Canada as business unfriendly.

The Govt won’t look at my cost/benefit analysis because it will cut into GDP tremendously.

Science is big business. As I pointed out recently, this 2011 article points out how big just the information sector of it is:

“If you are not a scientist or a lawyer, you might never guess which company is one of the world’s biggest in online revenue. Ebay will haul in only $1 billion this year. Amazon has $3.5 billion in revenue but is still, famously, losing money. Outperforming them both is Reed Elsevier, the London-based publishing company. Of its $8 billion in likely sales this year, $1.5 billion will come from online delivery of data, and its operating margin on the internet is a fabulous 22%.

Credit this accomplishment to two things. One is that Reed primarily sells not advertising or entertainment but the dry data used by lawyers, doctors, nurses, scientists and teachers. The other is its newfound marketing hustle: Its CEO since 1999 has been Crispin Davis, formerly a soap salesman.”

Since you have completely ignored my request for reliable references for your statement “Lack of vitamin B3 may cause…” I take it that you don’t have any. Fair enough, I’ll not ask again and your statement can be completely ignored.

I take it that you don’t consider niacinamide to be important enough as a medication to request that Pharmac supply it from the public purse? That’s OK as well; if it’s not needed to treat anything then we can safely rely on the multibillion, multinational, supplements industry to sell it to people who want expensive urine.

And why would the government look at your cost/benefit analysis for niacinamide? It’s Pharmac that has to look at the figures.

A lady, alternatively inclined,
Was surprised her homeopath opined,
I have to deplore,
My “cure” for your sore,
Has been, by Pharmac, declined.

OK, vitamin B3 deficiency causes pellagra. I’d forgotten – too many years since those lectures about vitamin deficiencies unlikely to ever be seen in NZ.

It’s very difficult to be B3 deficient in NZ because B3 is found in so many foods and can even be synthesised from tryptophan in dietary proteins. It takes a special effort, including an extremely restricted diet, to get pellagra in NZ.

I was bemused by the way you said “Lack of vitamin B3 may cause the 5 Ds. Diarrhoea, dermatitis, depression, dementia death.” Vitamin B3 deficiency either causes pellagra, or it doesn’t. There’s no need to say “may cause.” It makes you sound very uncertain about things, which is why I asked rather than look it up myself.

I would have phrased it somewhat more definitively: “Vitamin B3 deficiency is known as pellagra.”

“I was bemused by the way you said “Lack of vitamin B3 may cause the 5 Ds. Diarrhoea, dermatitis, depression, dementia death.” Vitamin B3 deficiency either causes pellagra, or it doesn’t. There’s no need to say “may cause.” It makes you sound very uncertain about things, which is why I asked rather than look it up myself.”

Sorry I should have said “any of,” note that in alcoholism as my ref said, the dermatitis may not appear.

The way you talk it appears you are not interested in people whose diets have become idiosyncratic.

“my house is either painted or it isn’t”. But it may only have been given a very thin coat. So your thinking is that a thin yellow coat of paint on a white house does not count as being painted. I say the house has some of the characteristics of being painted.

And I suggest “subclinical” pellagra may be eased and a person may feel better and get back to work with a small B3 supplement when they are not converting their tryptophan so well. Sorry I cannot supply a double blind placebo-controlled study.

In two-valued thinking there is only alternative or conventional medicine.

Mercola is a trained doctor who is trying to do a bit better.

Here he is referring people to something that may help for the future: a clip from Emory University looking at brain scans to try to remove some of the trial and error in depression treatment.

I feel a danger of the approach of several people on this group to Mercola is that they try to put people off looking at what he has to say. Don’t we want to look at all avenues at reducing the spending on antidepressants which must be about the second most costly to government?

Maybe this article will help Mercola sell some vitamin D or yoghurt if he sells it, but I don’t think especially him.

Oh dear I tried to post with a Mercola ref in it. Have you blocked Mercola URLs Ken?

Depression is a big medication cost. Must be about number 2.

Blocking all Mercola stuff would seem to be anti-science.

Two-valued thinking labels people as conventional, to be read, and alternative to be avoided.

Mercola is a trained doctor who wants to do better.

His article suggests vitamin D, but also attention to gut matters. The products could be bought anywhere. People may want to support him to give out more info. He also includes a video clip from Emory Unviersity looking at the future when it may become possible through a scan to say whether psychotherapy or medication is going to be more effective, saving money and time.

You said: “And I suggest “subclinical” pellagra may be eased and a person may feel better and get back to work with a small B3 supplement when they are not converting their tryptophan so well. Sorry I cannot supply a double blind placebo-controlled study.”

Does it surprise me that you can’t supply reliable references?
/rhetorical.

Since I had forgotten about pellagra, because I haven’t required the knowledge for my job within NZ, I’ve done the appropriate thing and caught up with the literature.

The medical literature says that either a person has enough vitamin B3, or they have pellagra. No in between. That’s how vitamins (and vitamin deficiencies) work.

As far as I can tell, there is a single case report of “subclinical pellagra”, dated 1970. I wouldn’t exactly call it massively overwhelming evidence that such an entity exists.

Are you adding a second case report? If you are, I would suggest that you send your paper to an appropriate journal for peer review and publishing rather than announcing it as a comment on Ken’s blog.

When I discuss a population, and say “many,” “most,” “usually,” or “tend to be,” you appear to think I’m meaning either all or none. Hint: look up the meanings of the words.

I do agree with you about biphasic thinking with regard to individuals. They are treated completely different from populations.

With individuals the situation frequently defaults to an either/or answer: a person either has appendicitis, or they don’t. A person either has influenza, or they don’t. A person either has a car, or they don’t. A person has either finished painting their house, or they haven’t. A person either has pellagra, or they have sufficient vitamin B3.

Soundhill – I think it morally wrong to take advantage of a person who died in tragic circumstances and attempt to use them to communciate things they would not have believed or advocated.

For example – Robyn Williams may have said:

“People who have seen a doctor and are under active treatment tend to be monitored as part of the treatment and usually do not successfully suicide.”

It is a perfectly reasonable statment and probably well supported statistically. Yes, he was an exception but it is surely dishonest to use that to imply that treatment and the care of a doctor promotes suicides rather than reduces the incidence.

I think you have elsewhere sort of implied that anti-depressants increase the incidence of suicide. I think this is also an immoral use of statistics. It is probably perfectly true that the proportion of people taking anti-depressants who commit suicide is greater than amongst those who don’t take them. But of course the two populations are different in that one show symptoms of depression and the other (mostly) don’t.

Reminds me of another misuse of statistics in the depression sphere I came across a few years ago. The media had been reporting that statistically more depressed adolescents commit suicide if they are taking antidepressants. In actual fact the statistics did not show that. The data showed that there was an increase in the numbers who mentioned suicidal feelings but in fact there was not an increase in the numbers who committed suicide

Unfortunately this misreporting lead to increased hesitancy in prescribing anti-depresants to a goup who would most like have benefited.

I see the missing article I repeated without the Mercola actual URL has been placed by openparachute onto “awaiting moderation.” If I had not bothered to repeat it without URL code them some people may have been denied the opportunity to know about teh Enory study and targetting anti-depressant vs psychotherapy as referred by Mercola. Or that he thinks inflammation may be involved: depression a possible physical cause. Some people are doing a better job of adjusting to higher grain (omega 6) since the beginnings of agriculture some 10,000 years ago.

Confounding factors need to be considered. “Weed” a name for marijuana may have more significance in it. People thrown by it and less able to cope with work and socially have been more at risk of suicide. The remaining population may have a lower risk of suicide in studies.

You said; “Seems a bit wrong. Thinking of kidney disease: we have a large reserve of capacity and are not disabled till some 90% is gone.”

Comparing “kidney disease” with pellagra is more than “a bit wrong.”

“Kidney disease” is a vague concept. It encompasses many different acute and chronic illnesses. It has many different causes, only some of which result in renal failure and reduction of renal capacity. Some people even consider reduced renal function of old age to be part of the concept. It has many different methods of treatment depending on each of the many causes. Sometimes there is no treatment possible (eg old age). Some, but not all, causes of “kidney disease” can be cured.

Pellagra is a single entity which has a single cause and a single cure.

It’s not even comparing apples with oranges, more like comparing a single apple with all motorised vehicles.

Now, that’s enough about pellagra. In this discussion, we’ve learned that I had forgotten about the disease and that you have ideas about it that are supported only by a single case report in the entire of the literature. The vast gulf between medicine and your ideas is unlikely to be bridged by any discussion on Ken’s blog, or even by direct evidence.

I may have a car but if the rust is progressing on it after the next warrant check it may not be legal to use it, which is not what many people think of as having a car to go about in. It will depend in part on the discretion of the warrant tester, but I might do better to get the rust attended to earlier, rather than leave it till it is uneconomic to do.

You haven’t answered how the diagnoser in your situation knows pellagra without the suggestions of skin lesions. Pretty severe if they turn up which is probably what your article had to wait for suggestion of. In the mean time depression may show up and be wrongly treated by the doctor.

“The ref I gave for alcoholism says it is not being recognised if the skin lesions don’t show” is not a question. Nothing to answer.

Besides: Now, that’s enough about pellagra. In this discussion, we’ve learned that I had forgotten about the disease and that you have ideas about it that are supported only by a single case report in the entire of the literature. The vast gulf between medicine and your ideas is unlikely to be bridged by any discussion on Ken’s blog, or even by direct evidence.

Rephrased, more specifically: I have a car, it hasn’t run in fifty years. It hasn’t been registered for longer. All the tires are flat. The wood of the wheels are rotting. Do I have a car, or not? The only possible answers are either “yes” or “no.”

(Then, if you answer “no,” you can explain why I was paid NZ$14,000 for it by someone who believed the answer was “yes.”)

And then you can answer the second question: ““A person either has influenza, or they don’t.” But it comes in various severities. I agree it is more two-valued if they die of it or not.”

Do they have influenza or not? Again, the only possible answers are either “yes” or “no.”

I’m repeating myself: with individuals (as opposed to populations), most questions do devolve to the either/or situation. Your comments have only supported that.

“Mercola.com makes no representation as to how complete, accurate, or current any information is on this Website.”

And:

“The information contained in the Website is provided for informational purposes only and is not meant to substitute for the advice provided by your doctor or other health care professional. You should not use the information available on or through the Mercola.com Website (including, but not limited to, information that may be provided by healthcare and/or nutrition professionals employed by, or contracting with, Mercola.com) for diagnosing or treating a health problem or disease, or prescribing any medication. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration unless specifically so stated.”

In other words, Mercola is telling you not to trust him, or his website.

I’ll say again (third time): Now, that’s enough about pellagra. In this discussion, we’ve learned that I had forgotten about the disease and that you have ideas about it that are supported only by a single case report in the entire of the literature. The vast gulf between medicine and your ideas is unlikely to be bridged by any discussion on Ken’s blog, or even by direct evidence.

“Twenty cases of pellagra, diagnosed on neuropathological grounds, were found among 74 necropsy cases of chronic alcoholism. Although these patients had presented with various mental, neurological and gastrointestinal symptoms, the diagnosis of pellagra had not been established clinically because, in the majority, there were no skin lesions.”http://www.ncbi.nlm.nih.gov/pmc/articles/PMC490893/
Twenty out of 74 is more than a quarter of alcoholics.

Mercola has to be very careful since he has been caught claiming that food can be medicine and vice versa without double blind controlled clinical trials. If Mercola would say something to the equivalent of “an apple a day keeps the doctor away,” he would be taken to court. Not that he would say that without warning about fructose.

You keep mentioning that reference. So what? It’s about institutionalised Japanese chronic alcoholics during the 1970s who had multiple dietary deficiencies. It’s totally irrelevant to modern New Zealand, or even modern Japan, and no further comment is needed.

You asked: “how do you claim that when…” What is the “that” I am supposed to be claiming? Vaguely worded questions frequently end up with the questioner denying the answer given is relevant. So, why should I reply? I suspect the answer is already in the previous comments, but you ignored it.

By the way, did I mention that I’ve stopped commenting about pellagra?

I’m bemused by the way you seem to believe every word Mercola says is true, when he himself denies it is “complete, accurate, or current.”

I contrast that to your apparent approach to websites which announce they try to make their information complete, accurate, and current. You know, places like http://www.cdc.gov, http://www.health.govt.nz/, http://www.pharmac.govt.nz/ and similar. You appear to completely disregard them as sources of complete, accurate and current information. Why the difference? (That’s a rhetoricaI question, I don’t expect an intelligible answer).

Oh, yes – FYI, I’ve stopped commenting about pellagra. Completely. There doesn’t seem any point in discussing it with someone who believes fervently in “subclinical pellagra,” which has only ever had one case report.

Well if you’ve stopped commenting about pellagra then I get the last word. Many alcoholics suffer from dietary deficiency, same as anorexics. Modern NZ does not affect that much.

Only one case report (the “that” you ask about) when so many cases are found at autopsy? I think that severely points to deficiencies in diagnosis. _If_ things have improved nutritionally since the 70s ( I doubt that with the increased disparity between high and low family incomes: top deciles increasing at many times the rate of the bottom decile which is hardly moving) then I say that attitudes forming in the earlier times are still hanging on from those earlier days about having to go alternative.

The point is to address the deficiencies first rather than start with prescribing anti-depressants. Eating abnormalities, anorexia, pica _may_ be helped by zinc supplementation as with diabetes which should be addressed first rather than drugs. Note prescribing chemists now have supplements on their shelves.

I don’t believe every Mercola word, as I said he is a doctor bemused by the inadequacies of conventional trreatment and looking for better. I do not believe amalgam replacement to be as advisable as some people claim on his site. Composite xenoestrogens are not addressed in all the articles.

I am not sure about fluoridation.

But I assimilate some things from his site. To be two-valued and entirely accept or reject I have found is a technique of disinformation specialists.

1. Mercola is not a medical doctor. He says so himself, on his website. He’s an osteopath with no qualifications that would allow him to be recognised as a doctor in New Zealand. (And, to be fair, I have no qualifications that would allow me to be recognised as an osteopath in the USA.)

2. The authors of your reference claim to have found pellagra at the autopsy of institutionalised Japanese chronic alcoholics who had multiple dietary deficiencies. The diagnostic features of pellagra, as stated by yourself, are diarrhoea, dermatitis, depression, dementia and death. Diarrhoea, depression and dementia are diagnoses of the living, they cannot be made at autopsy. The authors state they did not find the dermatitis of pellagra at autopsy. So, no diarrhoea, no dementia, no depression, no dermatitis – but yes, they’re dead. It makes me question their diagnosis. Didn’t you read past the abstract and question it as well?

3. The Japanese diet of the 1970s is not the same as a current New Zealand diet. It’s not even the same as the current Japanese diet. You are trying to argue that dietary deficiencies found in Japanese chronic alcoholics a half century ago are also found in non-alcoholic people eating a modern varied NZ diet. No matter how much you torture the data it is just not going to fit.

4. “Subclinical pellagra” has a single case report in the literature, and it’s not the reference you gave. It’s so old that I suspect the author has since died. That apparently makes you the only person in the world to believe in it as an entity. Have you written about it for the journals yet?

When your errors have been pointed out previously, you have stopped talking about radon, “lipophilic” fluoride, prescription omegas… many other subjects I invite you to do the same about pellagra.

You have not read what I explained.
You have it back to front. New Zealand osteopaths may not practice in the USA. You have to be an entire doctor to practise osteopathy there. That being said, New Zeland osteopaths, because they do not do a full medical training may spend their training years at polytech specialising more in some aspects of manipulative osteopathy than USA DOs, I am not sure.

Map of where in the world USA DOs have full practice rights or just manipulation. In NZ (orange area) it’s full rights.

I believe that would mean a USA DO could prescribe the contraceptive pill in NZ but not an NZ trained osteopath.

Mercola:
“And so, my qualifications: first and foremost, I am an osteopathic physician, also known as a DO. DOs are licensed physicians who, similar to MDs, can prescribe medication and perform surgery in all 50 states. DOs and MDs have similar training requiring four years of study in the basic and clinical sciences, and the successful completion of licensing exams. But DOs bring something extra to the practice of medicine. Osteopathic physicians practice a “whole person” approach, treating the entire person rather than just symptoms. Focusing on preventive health care, DOs help patients develop attitudes and lifestyles that don’t just fight illness, but help prevent it, too.

I am also board-certified in family medicine and served as the chairman of the family medicine department at St. Alexius Medical Center for five years. I am trained in both traditional and natural medicine.

In addition, I was granted fellowship status by the American College of Nutrition (ACN) in October 2012. In order to obtain fellowship status with the ACN one must meet a minimum of four requirements. Those requirements include: (1) co-author five or more publications relevant to nutrition in referred medical or scientific journals, (2) demonstrate significant experience in patient care, (3) hold a doctoral degree from an institution that is accredited by the Regional Accrediting Organizations, and (4) maintain status with the ACN.”

Mercola’s education.Education:

University of Illinois at Chicago – UIC 1972-1976
Chicago College of Osteopathic Medicine – Midwestern University 1978-1982
Chicago Osteopathic Hospital 1982-1985 Family Practice Residency. Chief resident 1984-1985
Board Certified American College Osteopathic General Practitioners July 1985
State of Illinois Licensed Physician and Surgeon

Then shows his medical certificate.
I won’t give his link since if I do openparachute may put this article on moderation. Maybe that is why you have not seen his data before, Stuartg.

Stuartg, I’m just progressing a bit with my final word, you wrote: “2. The authors of your reference claim to have found pellagra at the autopsy of institutionalised Japanese chronic alcoholics who had multiple dietary deficiencies. The diagnostic features of pellagra, as stated by yourself, are diarrhoea, dermatitis, depression, dementia and death. Diarrhoea, depression and dementia are diagnoses of the living, they cannot be made at autopsy. The authors state they did not find the dermatitis of pellagra at autopsy. So, no diarrhoea, no dementia, no depression, no dermatitis – but yes, they’re dead. It makes me question their diagnosis. Didn’t you read past the abstract and question it as well?”

Chromatolysis at autopsy was evidence.

You seem to be brushing people aside, Stuartg.

My article I have referred to several times is cited by many. Here is an example:
“Treatment-resistant alcohol withdrawal is a serious clin-
ical problem due to its high morbidity and mortality [1].
Studies and case reports over the past several years de-
scribe patients hospitalized for alcohol withdrawal who
develop delirium and receive high doses of benzodiaze-
pines [1-3]. These patients with alcohol withdrawal delir-
ium (AWD) tend to have costly and prolonged hospital
stays despite, and likely also because of, aggressive psychopharmacologic treatment involving not only large
quantities of benzodiazepines but also other sedatives
such as propofol or barbiturates [4].
Alcohol withdrawal delirium, a synonym for delirium
tremens (DTs), often poses a diagnostic dilemma given
the many possible etiologies of delirium combined with
the patient’s inability to provide a precise history. Delirium
with autonomic instability in alcohol-dependent
inpatients requires diligent clinical care. When a patient
fails to improve with escalating doses of sedatives, it is
essential for clinicians to broaden the differential diagnosis
and consider other medical conditions that may be
complicating the clinical picture. For example, alcoholdependent
patients may be prone to dehydration unrecognized head trauma, electrolyte abnormalities, infection,
pancreatitis, and nutritional deficiencies. Vitamin
B deficiencies in particular are well documented
among alcohol-dependent individuals—thiamine deficiency
being the most widely described in the medical
literature [5]. However, many patients with AWD continue
to do poorly despite supportive care and treatment
with sedatives and thiamine supplementation.
Patients admitted for alcohol withdrawal almost universally
receive thiamine on admission; however, the role
of niacin deficiency in AWD has largely been ignored
for several decades [6]. Although endemic niacin deficiency
has essentially been eradicated in most Western
countries [7], pellagra may account for a significant portion”
of AWD [5,8-10]. Pellagrous encephalopathy presenting as alcohol
withdrawal delirium: A case series and
literature review
Mark A Oldham* and Ana Ivkovic
Oldham and Ivkovic Addiction Science & Clinical Practice 2012, 7:12http://www.ascpjournal.org/content/7/1/12

Re-read what I said about Mercola: “Mercola is not a medical doctor. He says so himself, on his website. He’s an osteopath with no qualifications that would allow him to be recognised as a doctor in New Zealand.”

I said what I meant. There is no need for you to re-interpret it. I don’t even know how you thought you could try. All that you copied from his website only says the same. It was what I had read and then summarised in a single sentence.

Just as a comparison:
Mercola training = 4 years, NZ doctor = 6 years.
Mercola then registered, NZ provisionally registered, with another year to go before registration.
Mercola 3 years residency in osteopathic family practice, NZ 3-4 years further training, passing GPEP1 and GPEP2 examinations.
At that stage Mercola is an “osteopathic physician,” a NZ doctor is just qualified as a GP.
I make that 7 years training for Mercola (even counting the year as “chief resident” as training where most wouldn’t), 10-11 years for a just qualified NZ General Practitioner.

In other words, anyone registered as a doctor in New Zealand has done considerably more formal training than Mercola. Mercola would have to achieve the same before he would even be considered for registration as a doctor in New Zealand.

You don’t need to try to re-interpret Mercola’s words; he says exactly what he is and what he does on his website.

“There are currently more M.D. schools than D.O. schools offering medical training in the United States. However, the D.O. medical profession is expanding rapidly, with approximately 1 in 4 medical students now entering a D.O. medical school.[74][7] Both DOs and MDs have the option to train and practice in any of the medical specialties and sub-specialties. One exception is the Neuromusculoskeletal Medicine specialty which is only available to D.O.s who have completed a one-year traditional internship.[75]

Both degrees are recognized internationally as a medical degree. Accredited D.O. and M.D. medical schools are both included in the World Health Organization’s World Directory of Medical Schools.”

Richard as in medicine in music we had developments in instrumentation. Though a “fortepiano” or “loud soft” was developing in JS Bach’s day, he would still be writing for an organ or harpsichord which does not lend itself to giving emphasis to single notes in a phrase. How was it indicated to make a note stand out in a phrase? Notes could be shortened or lengthened, both by changing the rhythm a bit temporarily, or keeping the beat regular and shortening a note, or indicating a longer note in a run of short ones.

The voice tends normally to be legato: notes smoothed together. So with the organ or harpsichord I believe it was by shortening a note that made it stand out. A dot over the note was the indication, and I believe that indication to articulate a note hung on, though it has arrived in the 20th century as taught by many teachers as the instruction to shorten a note by half. I don’t think that makes sense in much of Mozart’s music.

Richard you are exhibiting a technique of debate where a word gets reduced to a smaller meaning. Recently I talked about the word “your” or “you.” “You do it like this.” It can mean anybody concerned depending on the context. Some people try to get and emotional point and say strongly they do not.

According to Webster online having questions about something does not have to mean you want to ask them. You are just offering them to whoever as points for possible discussion.

Webster:
: a sentence, phrase, or word that asks for information or is used to test someone’s knowledge

So far you are just doing your usual thing: pontificating and making stuff up as you go along, addicted to the attention you both seek and receive in forums such as this And so it will go on, diving and weaving, shifting the goalposts, anything, anything, to drag out the attention.

Richard
Actually I am in quite good company. I learnt about dots from Isidor Saslav a former concertmaster of the NZSO at a university extension course.

It was very surprising to me since it had been strongly drummed into me that a dot over a note meant shorten it by half. Saslav said, through his examinations of many Haydn of Mozart scores, that he thinks a dot over a note means articulate the note or make it stand out.

Stuartg seems to have certain things entrenched in his beliefs that I feel could be challenged.

Your own beliefs are being challenged, and all you do when you are pointed out in error is to change the subject.

I pointed out Mercola’s training posts; you added in jobs which weren’t actually training posts according to Mercola and counted them as training. Don’t you believe what Mercola says on his own website?

I believe Mercola when he says his website isn’t “complete, accurate, and current.” Don’t you believe him? Are you saying he is lying about this? If so, where else could he be lying?

I tell you that Mercola is an osteopath and cannot be registered as a doctor in New Zealand. Are you saying that I am wrong? Are you saying that he can be registered as a doctor in New Zealand? Proof, please.

I pointed out the number of times that your own reference has been cited, a number actually given by your own reference; you then tell us that your own reference is incorrect and give us a different number instead. Don’t you believe your own reference?

I agree with Richard. You pontificate and make things up. You will never admit that you could be wrong or make an error. You will never make an allowance that somebody else could be correct.

You say that I am entrenched in my beliefs. Are you saying that you are not? I was in error, having forgotten my training about B3 and pellagra. I admitted the error and refreshed my knowledge by reading reliable references. Did you admit your error and change your belief when I pointed out that you are probably the only person worldwide who believes in “subclinical pellagra?”. Did you admit your error that radon depends on latitude? Or earthquakes? Or water supplies? Did you admit that the diet of an institutionalised chronic alcoholic in Japan during the 1970s is different from the diet of a modern New Zealander? Did you admit that you could be wrong with your beliefs?

If you can show, with reliable references, that I am wrong, then I will admit my error. Will you? I, and others, have pointed out where you are wrong many times. Have you ever admitted an error? I cannot recall a single occasion.

If you cannot recognise your own errors when they are pointed out, it indicates that you are following beliefs, that you are not following the scientific method.

Now, I suspect that we will not get any brief, succinct answers to any of these questions. I suspect that we will get one of two responses, one option would be pontification, the other is that you completely ignore this post and change the subject.

Stuartg
“I pointed out the number of times that your own reference has been cited, a number actually given by your own reference;”

A paper cannot give the number of times it has been cited. Do I misunderstand you. Google Scholar adds up the number of up times when an older paper is cited by a newer one. The 2012 article I did a long quote from is one that cited my old reference.

“I pointed out Mercola’s training posts; you added in jobs which weren’t actually training posts according to Mercola and counted them as training.” You are losing it Stuartg. I said I made a mistake immediately after posting that. I had misread.

I think MO is a typo it should be DO. There is no MO osteopathic medicine degree in USA to my knowledge. And note all the other doctors have a “D”.

If NZQA don’t need to assess a degree it would seem pretty silly if the doctor is not qualified to work here.

The page says it is operative from 09/06/14

I can’t download the Medical Register, but you might be able to and see if anybody has “DO” after their name. Though DOs are probably pretty much in demand in USA so they may not be emigrating. Might be one on a visitors visa in a hospital?

Note “osteopathic medicine”: the word “medicine” is not part of NZ osteopathic quals.

Stuartg: “Did you admit that the diet of an institutionalised chronic alcoholic in Japan during the 1970s is different from the diet of a modern New Zealander?”
As I quoted: “Although endemic niacin deficiency
has essentially been eradicated in most Western
countries [7], pellagra may account for a significant portion”
of AWD [5,8-10].”

soundhill1 appears to think that comments on a blog should be adversarial.

I thought it was about sharing knowledge and learning.

When I point out simple errors, the reason is to help that person with their knowledge, to help them with their thinking.

At the moment, I feel more like a teacher with a particularly recalcitrant student who refuses to acknowledge the possibility of their own error and that there may be greater authorities in a subject than their self.

Stuartg wrote: “Look on your reference, look for the highlighted word “cited.”
Thanks for confirming you didn’t read you own reference.”

You are confusing Pubmed and Pubmed Central.

“PubMed is a free search engine accessing primarily the MEDLINE database of references and abstracts on life sciences and biomedical topics. The United States National Library of Medicine (NLM) at the National Institutes of Health maintains the database as part of the Entrez system of information retrieval.”

“PubMed Central (PMC) is a free digital repository that archives publicly accessible full-text scholarly articles that have been published within the biomedical and life sciences journal literature.”

PMC list ctations ONLY by other FULL TEXT ARTICLES IN THEIR FREE FULL TEXT DATABASE.
Google Scholar lists as many as it can find, including of course the small subset of free PMC articles.

Please take this in the spirit that it is intended, advice that may make commenting happier for yourself.

We cannot read your mind. We can only read what you write.

A reference by itself does not help explain what you are getting at. All it does is provide a mass of words to wade through.

When you supply a reference, it really helps to say why you are using the reference. If it’s to clarify your ideas, then show where it clarifies your ideas; if it’s to argue against someone else’s idea, then show where it does so.

Take your reference: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC490893/ Initially, it appears straightforward: Autopsies were done in the 1970s on institutionalised Japanese chronic alcoholics with multiple dietary deficiencies. The authors say they saw pellagra.

First problem: they made the diagnosis without any of the clinical signs of pellagra being present, so why couldn’t their findings be explained by the multiple dietary deficiencies or the alcoholism itself? Immediate doubt is cast on the conclusion of the paper.

Second problem: it studied institutionalised Japanese chronic alcoholics with multiple dietary deficiencies in the 1970s. How does the population discussed in the paper compare with the current New Zealand population? Any relationship elludes me completely.

Third problem: you say it has been cited many times. The reference itself has the number of times it has been cited at the top of the page. Clicking on the word “cited” takes you to those eight papers. Others have obviously concluded that the paper is not of ground breaking importance.

Most important problem: I have no idea why you gave the reference! It’s vaguely interesting by itself, but why did you cite it? You have not explained why you think that it is supportive of your ideas. Or do you think it is opposing your ideas? We just don’t know because you didn’t tell us when you cited it.

Instead, you left it up to us to guess: Is it the author? The institution? The dietary deficiencies? The alcoholism? Japan? The Japanese diet? The era it was done in? The population studied? The authors don’t mention “subclinical pellagra,” so I can eliminate at least one possibility of why you cited it.

Making others have to guess why you cited a paper is certainly not the scientific method in action.

Please, in future, tell us why you are citing a reference. Maybe we could understand you a bit more. Maybe you would get less frustrated. You would certainly get less questioning about why you cited the reference.

Here are the words:
“Dr Gault is permitted to practise medicine in General Practice at Lake Surgery under the supervision of Dr Francine Meuli between 01 March 2014 and 28 February 2015; at Taupo Medical Centre under the supervision of Dr Francine Meuli between 01 March 2014 and 18 March 2014; under the supervision of Dr Francine Meuli between 01 March 2014 and 28 February 2015.

The purpose of this registration is to enable Dr Gault to complete Council’s requirements for registration within the general scope.
Definitions of scopes
Provisional General

All new registrants, regardless of seniority, must work under supervision for at least their first 12 months in New Zealand to become familiar with the culture.

During this time they are registered within a provisional general scope of practice and their performance will be assessed by senior colleagues.

They will be required to complete certain requirements to be registered within a general scope.

The only exception to this supervised period is for New Zealand and Australian graduates who have already completed their internship in Australia.”

I told you I had read your reference. Didn’t you believe me? Copy and paste didn’t change it.

BTW, the person you referred to is under general registration. That means exactly the same practice restrictions as a brand new New Zealand or Australian medical graduate. So, yes, very much like a PA. My knowledge comes from having to supply both general and vocational oversight myself.

But, this is all about you prevaricating and ignoring where previous errors have been pointed out.

If you google: “doctor of medicine” md “United States of America” site:mcnz.org.nz

you can see a lot more.

Unfortunately the google cache is out of sync with the mcnz site. So you need to click on the little down arrow indicator at the right to see what is in the cache quite often, though not always. At the time a accessed it the link above was in sync.

To see DOs change “Doctor of Medicine MD” to “Doctor of Osteopathic Medicine DO”

“People do not and should not trust corporate/political junk science of the “natural” health industry. The conflict of interests in corporate “junk science” of the “natural healht industry” undermines science”

Stuartg: wrote “BTW, the person you referred to is under general registration. That means exactly the same practice restrictions as a brand new New Zealand or Australian medical graduate. So, yes, very much like a PA.”

A physician assistant does something like a nursing degree (3 years) then as per your link: “The overseas model is for a two-year postgraduate qualification combining academic study and work placements, with a focus on clinical and communications skills”

Stuartg wrote (10:32) “Third problem: you say it has been cited many times. The reference itself has the number of times it has been cited at the top of the page. Clicking on the word “cited” takes you to those eight papers. Others have obviously concluded that the paper is not of ground breaking importance.”

My 10:02 post explained.

Again: The paper is one of the free entire articles which is what Pubmed Central is about. The word “cited” gives a link to the other articles in the PMC database. Journals who do not wish their entire articles to be free will not show as cited. It is nothing to do with importance.

Stuartg wrote: “Most important problem: I have no idea why you gave the reference! It’s vaguely interesting by itself, but why did you cite it? You have not explained why you think that it is supportive of your ideas. Or do you think it is opposing your ideas? We just don’t know because you didn’t tell us when you cited it.”

Why did I cite it?

My hypothesis is that patients are turning to alternative medicine because regular doctors are not meeting their needs.

The article points up lacks in regular doctors’ understanding of pellagra. It is cited by another I quoted from which says if valium and vitamin B1 are not curing the patient from delirium tremens (alcohol withdrawal) then as an afterthought try vitamin B3. Maybe alternative medicine would try things in the other order and maybe even be able to avoid the valium withdrawal.

People are suspicious of medical authority. They do not have to take treatment but often are at a loss to get to better trained physicians.

If as you said you trained a bit in mental health (when you aimed the “flight of thoughts” or some such diagnosis at me) then presumably have have learned about alcoholic deaths. People are searching for better. And they are blamed for that search.

You question whether the original article even should be saying it is pellagra because the people are dead so their depression &c cannot now be seen for diagnosis. The diagnosis was by microscopically observing.

Responding to your 1:03 post. Again, you have not made yourself clear about why you cited the paper. You seem to have given at least four reasons in this comment.

1. Are you telling us that a paper about autopsy findings in institutionalised chronic alcoholics in Japan during the 1970s supports your hypothesis that patients are turning to alternative medicine? If so, HOW?

If you want papers to support that hypothesis, there are many in the recent medical literature. It’s not exactly a new hypothesis and many would consider it to be an accepted interpretation of recent research, including both Ken and myself. But come on now, using 1970s autopsy reports to explain current societal behaviours?

2. Do you mean that doctors don’t understand pellagra? Could be true, since it’s very rare to see anyone with the condition these days. The problem with the paper, as I explained earlier, is that the only diagnostic feature of pellagra detectable at autopsy is the dermatitis. The authors say that the dermatitis wasn’t present. Apart from the dermatitis, there are no histological findings that are specific for pellagra.

NB: chromatolysis – I had to look it up in a 1940s histology text I have – is just an old term for a particular form of neuronal cell death. Common causes are Alzheimer’s disease, alcoholic encephalopathy and ALS. Since all of the subjects of this paper were alcoholics, why would a histological finding related to alcoholism be diagnostic of anything but the alcoholism? At best, the authors’ diagnoses are questionable.

3. Or maybe you meant that DTs should be treated with vitamin B3 rather than current best practice? The paper doesn’t even mention DTs, so it can’t support that, either. Someone with delirium tremens needs treatment right now, otherwise there is a high chance they will die in the next couple of days. That treatment isn’t vitamins.

4. Suspicion of medical authority or people seeking better trained physicians? Nope, the paper doesn’t help there either. That’s societal behaviour and it takes us back to your first reason – where I questioned how 1970s autopsy reports relate to current societal behaviour.

I still can’t see a reason why you cited that paper.

I previously said that your comments were reminiscent of flight of ideas. At that time I backed up my comment by listing the ideas that you had flitted between on that single thread. For some people, flight of ideas can be considered a symptom, like coughing, sneezing, or vomiting. It’s not a diagnosis.

Sometimes things work like a tank of water which can give out water with very little slowing effect until nearly empty then it suddenly stops.

Your two-valued pellagra or not diagnosis misses that slight slowing, I suggest.

Here is some more recent discussion of pellagra including the history. I think it suggests that what you call alcoholic encephalopathy ( as was shown by chromatolysis) might be averted by early enough vitamin B3.

“Common vitamin replacement (usually B1, B6 and B12) therapy may aggravate or precipitate alcoholic pellagra encephalopathy, as it happened in the case reported here. Both his confusion and dystonia were exacerbated by vitamin B1, B6 and B12. He improved only after the addition of nicotinic acid treatment. The whole B complex seems necessary in these cases, as in addition to treating the pellagra the development of a Wernicke encephalopathy can be prevented.”

That’s a lot of time on pellagra.

Now let’s move on to vitamin D.

NZ health system is catching up a bit, with Australia:

Here is a chance to submit on manufacturers voluntarily adding vitamin D to food.

A problem with supplementing vitamin D and calcium is that there may be calcification of the artery walls. To avoid that, alternative medicine is saying vitamin K2 should be included. That is quite different from vitamin K1 which helps coagulate the blood. If I submit I will talk about that.

Soundhill, (@ comment) I don’t care who you learned about “dots” from. It’s just a weak appeal to authority.

Your little excursion into an subject area (music) that I can modestly say is one that I have reasonable expertise in, has again demonstrated to me your predilection for bluster and puffery.

It is apparent you know little in regard to musical articulation both in regard to various instrument mechanics, the notational and interpretive practice of different periods and of the performance styles of various periods and genres. In particular you fail to appreciate that the vast scope of variation in these areas impacts upon musical articulation such that your comments or query are basically ludicrous (as far as I can make a query from you out – and I gave you ample chance to put a question) .

This didn’t stop you from puffing your chest out and pretending you had some expertise in the area.

It’s a recurring pattern. You simply like the sound of your own voice.

For example I learned that a spike over a note shortens it to more like a quarter, as opposed to a dot which makes it half.

But Louis Spohr (Violin School, probably around 1840) associates a spike with “detaché” bowing. “This bowing is made with a steady back-arm and as long strokes as possible, at the upper part of the bow. The notes must be perfectly equal both in power and duration, and succeed each other in such a manner, that, in changing from the down to the up-bow, or the reverse, no break or chasm may be observed.”

There you go again.The whole purpose of your reply is to create the pretence that you know what you are talking about. A panicked search for a quote to copy-paste with it makes this observation leap out more clearly.

I’m not interested in what you think you know.
What is your question?

Although this sideshow is well off-topic I’m pursuing it because it is illustrative of your approach in this blog.

Thanks, Richard, I watched. Then I was offered a menu of other vids, and chose, “Positive Thinking.”

People need success. If kids are given problems too hard in maths they may go back to counting on fingers.

If you taught music you would need a balance between encouragement and development of self criticism by the pupil. Adult pupils learn for enjoyment, it’s no good saying to them they will never be as good as many children.

In this thread we have been talking about doing things to change others’ lives. It makes it harder to turn it into just an enjoyable hobby to interact here.

Apparently doctors and dentists have high suicide rates, and a short life expectancy. I think that that may mean they are not having enough success in their lives as they see them. Sometimes I think the tools they are trained to have are not sufficient. Doctors of Osteopathic Medicine, as Mercola says, are trained to work more with preventing people from getting ill.

By the way:
“Graduates of osteopathic medical schools in the United States (osteopathic physicians) should not be confused with osteopaths, who are trained in the European and Commonwealth nations. Osteopaths (the term used for non-American-trained practitioners who practice osteopathic manipulation) are not physicians. Their training is similar to physical therapy and they are not licensed to prescribe medications or perform surgeries.”http://www.digplanet.com/wiki/Physician

You ask about osteopaths, maybe they have some risks reduced such as drugs for prescription or anaesthetics, but about doctors of osteopathic medicine I don’t know.

I will interpret your refusal to rapidly supply an answer here to be an admission you don’t know what you are talking about. That you are in the habit of making unwarranted claims and can therefore be ignored from now on.

That would be nothing new as you have ignored every substantiated fact I have put to you .
You know you are funded by the corporation, so are you now telling people and your colleagues that you are on an unemployment benefit?
You have a conflict of interest and bias. If you do not you prove it , I do not need to prove your income.
You have already established your ignorance about the well known state of corruption within politically funded and for- profit science.
Corruption which is endemic in the industry of political, wall st and corporate funded brand ” Junk science”.